Cited by 117Reproductive Health and ContraceptionBone health and osteoporosis researchMenopause: Health Impacts and Treatments

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Spinal bone density in women using depot medroxyprogesterone contraception*1

CUNDY, T·1998·Obstetrics & Gynecology

DOI 10.1016/s0029-7844(98)00270-1

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Abstract

OBJECTIVE: To determine factors possibly associated with reduced bone density in women using the injectable contraceptive depot medroxyprogesterone acetate. METHODS: In a cross-sectional study, bone mineral density of the lumbar spine was measured by dual energy x-ray absorptiometry in 200 current users of depot medroxyprogesterone acetate who had used this method of contraception for 2-26 years and compared with 350 control subjects. Bone density results are expressed as standard deviation scores (z score). RESULTS: The bone density was significantly lower in depot medroxyprogesterone acetate users (mean z score: -0.65, 95% confidence intervals [CI] -0.80, -0.49, P < .001). Bone density was significantly reduced in nonsmokers and smokers, and there was no significant difference in mean z score between smokers and nonsmokers (mean -0.75 versus -0.58, P=.30). Women who had started depot medroxyprogesterone acetate after the age of 20 years and who had used it for 15 or fewer years had a significantly higher bone density than the remainder of the cohort (mean -0.45 [95% CI -0.62, -0.27] versus -1.02 [95% CI -1.32, -0.73], P < .005). Bone density in depot medroxyprogesterone acetate users was not related to current age, parity, body mass index, calcium intake, or exercise. CONCLUSION: Depot medroxyprogesterone acetate use is associated with a significant reduction in bone density, and although a high proportion of depot medroxyprogesterone users do smoke, the reduction in bone density cannot be explained by smoking. Women who use it for a long time and those who start it before peak bone mass is attained may be at highest risk.

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Authors: CUNDY, T.
Affiliations: University of Auckland (NZ)
Corresponding author: CUNDY, T
ORCID: CUNDY, T
Venue: Obstetrics & Gynecology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1998-10
Volume: 92
Issue: 4
Pages: 569-573
ISSN: 0029-7844 (ISSN-L)
DOI: 10.1016/s0029-7844(98)00270-1
OpenAlex: W1977489294
Cited by: 117
References: 15
Citations by year: 2021: 1 · 2020: 2 · 2017: 5 · 2016: 2 · 2015: 3 · 2014: 4 · 2013: 4 · 2012: 1
FWCI: 11.24
Type: journal article
Language: en
Open access: closed
Locations: Obstetrics and Gynecology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Keywords: depot medroxyprogesterone acetate, injectable contraceptives, bone mineral density, lumbar spine, osteoporosis risk, smoking, duration of contraceptive use, peak bone mass, women
MeSH terms: Adolescent, Adult, Contraceptive Agents, Female, Cross-Sectional Studies, Female, Humans, Middle Aged, Spine, Bone Density, Medroxyprogesterone Acetate

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Spinal bone density in women using depot medroxyprogesterone contraception*1

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